9903-010 (RPL)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
- License # Lic. Class Exp. Date
574127 A 8/31/99
_
Patel - ' Signature of Contractoi "
— -- ryZ_ " N
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
(_ ) : I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code).
( ,)- I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
() I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I 'hereby affirm under penalty of perjury one of the following declarations:
(• ) .1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
() I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Caner Policy No.
S'i'�vrr 1, Lim) 1242,679-943
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) I certify that in the performance of the work for which this permit is issued,
I shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions. .y
pate: - Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this. application becomes null and void if
-,workis not commenced within 180 days from date of issuance of such
permit, or cessation of work for'180 days will subject permit to cancellation.
I' certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent) "�- ='%Date
BUILDING PERMIT PERMIT
9#903-014)
DATE VALUATION $22,9 l%.0O LOT TRACT
2-
JOB SITE
ADDRESS 7"91 Sl!'.rN A COURT
APN -
OWNER
CONTRACTOR / DESIGNER / ENGINEER
C.A.:tTIERI..NE MIN
SITEV.E DODSON CONST. RUC'T'ION
78-691 SIENA COURT
73-011 COUN.IRY CLU;31.7R., SUITE F4
Uk QUiNTA CA. 92253
PALM D'f:S-E'Wr CA 92MO
q&))346-4032 CRIN 1044
USE OF PERMIT
int UL ANEVOR'SYA
1Oj>; L SFl r1LttiR.N(' 63� tt�IEC�S Slip LL BE IN Al. RtV PLASi.UR
l 1�fSP1:,L.'f.WN.
trC a, ANA DiC"R SOA 20,0u0.60 i.S
LSTIMATE D COST Or CQ)NS'6`RUCfIGN
201000.00
ii"EIttv11IT YCE Si1M1A4ARY
PLAN CHECK .FEE 1014)D0439-318
rp0NS"M3lC11V0N 117. ►�E toll -W-419-000 o ll-0I)t?-4111
.9-00
,'tfE IIJAN1C41L,1",1T -• K)01. 101`UUO 421.000 S 1.OfJ
E L.Lit-fRICAL M, -- POOL 11.01-W®-4,10-600
1111UNIBING EE...1%C)OL, 101 -000 -419 -WO
r`
w
S R -'l . 1'A.L CX)NS1"t1UCM.0N AND PIAN (THECK
�-a37 Si
LESS 1'R1 -PAID FEES
$rn00
TOTAL PERMIT FER8 DUE NOW
RECEIPT
DATE
BY Y
�1
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE.
INSPECTOR
OPERATION
DATE
TINSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
Electric Bond —1 177
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover Af
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I. '
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
P/L
BLOCK PLANTER WALL @ +1-=
25'
P/A
17'-6"
P/A
- I * -1 , -.
P/A
slider
f.
THREE 18" CUSTOM CASCADES
slider
39'
LIGHT SWITCH
RESIDENCE
RAISED BOND BEAM CROSS-SECTION
OUTSIDE EDGE FINISH
WATERPROOF BOND BEAM
DECKING
Cx2ADE
•►1Rmy �:.e�al• a ..�
slabs- sewers- . i!
walls, sprinklers, telephone lines or shrubs.
When access is made through a ne*ghboca
property understood that you.the •.n-
o' " ' ` -assume
respausibilityL
ti isienature
14'-3"
GENERAL SPECIFICATIONS
SIZE 9 X 39' I
r
NREA355 PERIMETER 97 ,
)EPTH 3X5X3 j
-ILE CHOICE GROUP sQ.90
1B6 40'@ +12"
.OPING CANTILEVER
MOTOR HP cTA gLTF HE1
M"Mlt'RFN=====mmW
FILTER STA RITE 300 SQ FT
FILTER RATE 1 o;? GPM
HFATFR 1 AARS S17F 400 RTI I
SUCTION LINES 2 "
RETURN LINES 2 "
SKIMMFR mnnp1 AMERICAN
P/L
Mg
10'-8"
LEAVE DIRT
IF NECESSARY
I GASLINE BY SDC FT. 100
POOL LIGHTS 400 W CLOCK T104R
I
ELECTRICAL BY. SDc F7r. 250
AUTO CLEANER
5'-0"
PLASTER COLOR WHITE
DECK BY. SDC SQ. 738
DECK TYPE SLT FNSH SD BUFF
STEP FT.
III
-
LITE i 0 WATTS
RI LEVEL TS 22" 27"
DAMWALL .
III
SPILLWAY ")741v* WIDE
PI L OPEN &&OSED
III
III
3
5
3
III
III
slider
39'
LIGHT SWITCH
RESIDENCE
RAISED BOND BEAM CROSS-SECTION
OUTSIDE EDGE FINISH
WATERPROOF BOND BEAM
DECKING
Cx2ADE
•►1Rmy �:.e�al• a ..�
slabs- sewers- . i!
walls, sprinklers, telephone lines or shrubs.
When access is made through a ne*ghboca
property understood that you.the •.n-
o' " ' ` -assume
respausibilityL
ti isienature
14'-3"
GENERAL SPECIFICATIONS
SIZE 9 X 39' I
r
NREA355 PERIMETER 97 ,
)EPTH 3X5X3 j
-ILE CHOICE GROUP sQ.90
1B6 40'@ +12"
.OPING CANTILEVER
MOTOR HP cTA gLTF HE1
M"Mlt'RFN=====mmW
FILTER STA RITE 300 SQ FT
FILTER RATE 1 o;? GPM
HFATFR 1 AARS S17F 400 RTI I
SUCTION LINES 2 "
RETURN LINES 2 "
SKIMMFR mnnp1 AMERICAN
ff JC I M, urm LU V~i
CITY OF A QUINTA
Name: CATHERINE LINN
BUILDING & SAFETY DEPA' TIENT 3:
Ar1riracc•7R-6O1 SIFNA MI IRT
P/L
Mg
10'-8"
STEP TRIM
PATTERN TBS 2
f a -
2Q�
DESIGNERSED
CHARD/EV
DATE
2-22-99
REVISED
I GASLINE BY SDC FT. 100
POOL LIGHTS 400 W CLOCK T104R
slider
ELECTRICAL BY. SDc F7r. 250
AUTO CLEANER
PLASTER COLOR WHITE
DECK BY. SDC SQ. 738
DECK TYPE SLT FNSH SD BUFF
STEP FT.
SPA SPECS.
-
LITE i 0 WATTS
RI LEVEL TS 22" 27"
DAMWALL .
UA WALL TOP ♦ "
SPILLWAY ")741v* WIDE
PI L OPEN &&OSED
ff JC I M, urm LU V~i
CITY OF A QUINTA
Name: CATHERINE LINN
BUILDING & SAFETY DEPA' TIENT 3:
Ar1riracc•7R-6O1 SIFNA MI IRT